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General NPI Number Information
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NPI Number | 1811315989
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Entity Type | Organization
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Legal Business Name | FAMILY WELLNESS ACUPUNCTURE INC
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 04/04/2014
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Provider Practice Location Address
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Address Line | 4950 BARRANCA PKWY SUITE 301
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City | IRVINE
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State | CA
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Zip | 92604-4671
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Country | US
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Telephone | 949-836-2857
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Fax | 949-861-3270
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Provider Business Mailing Address
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Address Line | 4950 BARRANCA PKWY SUITE 301
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City | IRVINE
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State | CA
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Zip | 92604-4671
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Country | US
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Telephone | 949-836-2857
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Fax | 949-861-3270
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Authorized Official
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Title or Position | OWNER
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Name | MS. RYOKO TAKAYAMA
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Credential | L.AC
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Telephone | 949-836-2857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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